Bedside insertion of inferior vena cave filters in the intensive care unit

BACKGROUND: Several authors have showed that bedside insertion of inferior vena cava fi lters (IVCF) is feasible and cost effective, with the additional benefit of not having to transport a critically ill patient to the operating room or radiology department. The objective of this study was to examine our experi ence of 158 IVCF insertions at the bedside in the intensive care unit. STUDY DESIGN: A prospective, observational study of bedside IVCF insertion performed by t he authors from February 1996 through August 2000 was undertaken. RESULTS: One hundred fifty-eight patients underwent bedside IVCF insertion in the in tensive care unit. The mean age was 42.2 years (SD 17.5 years). The mean In jury Severity Score of the trauma patients was 27.3 (SD 14.5). The majority of patients (90%) had a prophylactic indication for IVCF insertion using o ur institutional guidelines for venous thromboembolic prophylaxis for traum a patients. All IVCF insertions were successfully performed at the bedside after iodinated contrast or carbon dioxide cavography. The mortality was 11 % (n = 18), none attributable to the IVCF insertion or cavagram. There was one asymptomatic cava occlusion and one postinsertion pulmonary embolus in a patients with a subclavian vein thrombosis. CONCLUSIONS: Our results demonstrate the safety and efficacy of IVCF insertion at the be dside in the ICU. This method offers less resource use and more safety for critically ill patients, avoiding the hazards of intrahospital transport. ( J Am Coll Surg 2001;192:570-576. (C) 2001 by the American College of Surgeo ns).